Woman temporarily paralyzed after a sit-up accident at the gym. Are you in danger too?

In January 2016, law student Marcelle Mancuso was going through her normal workout at her gym in Brazil when something went terribly wrong. The 23-year-old law school graduatewas doing an inverted sit-up — a move that requires hanging upside down from an apparatus and doing sit-ups in that inverted position. In the midst of it, the strap holding Mancuso’s legs above her body broke.

The accident sent Mancuso flying headfirst to the floor, where, upon landing, she broke her fifth vertebra. “I lost all the movements from the neck down when I hit my head on the floor,” she remembered of the event. “I could move my eyes. I had to keep calm and began to pray.”

Once at the hospital, doctors told Mancuso that she was likely going to be tetraplegic — meaning she would be paralyzed from the neck down. “The doctors did not know if I would walk again or if I would stay on a bed forever,” she told the Independent. With a rigorous physical therapy practice and a bit of luck, Mancuso beat the odds, posting an Instagram six months later of her walking.

Although Mancuso is fully recovered, her accident raises concerns about inverted sit-ups.

Who should do inverted sit-ups?

According to experts, inverted sit-ups should only be done by advanced trainers. Since personal trainers consider upside-down sit-ups (another term for inverted sit-ups) the “peak of ab fitness and training,” they should be done only by those who have strong core muscles and experience with inversions.

What muscles does it work?

In a video demonstrating the movement, a training expert with Livestrong explains that the move works three different areas of the body: hips, lower back, and abdominals. Breathing, considering you’re working three areas at once, is crucial.

What precautions do you need to take with this exercise?

One of the most important parts of this exercise is making sure your legs are secured. Whether this means wedging them between bars or — like Mancuso — using an apparatus with a strap, it’s critically important to make sure your legs are stable. Training experts say the key to avoiding injury, once you’re safely in the move, is to keep your movements “slow and controlled.”

What are the risks associated with inversions?

Falling during an inversion is, of course, the biggest risk, and as Mancuso’s story proves, this is extremely dangerous. But even if your legs are fully secured, there are other potential problems. According to the Mayo Clinic, being suspended upside down increases your blood pressure —meaning anyone suffering from high blood pressure, heart disease, or glaucoma should talk to a doctor before trying it.